Guest guest Posted July 24, 2001 Report Share Posted July 24, 2001 Here is a case history from a book I am helping my teacher to write on kidney disease that may be of interest. Case 2: Chang, a 59-year-old male cadre. This patient’s first visit was on June 23, 1992. For the previous year he had been feeling heat rising from his epigastrium, distention in his head, and dizziness. He had a red face, he was irritable, and had palpitations. His tongue was red with a white, greasy coating, and his pulse was slippery and wiry. A Western doctor diagnosed brain arteriosclerosis. He was treated with Chinese and Western medication without result. Dr. Chang found this patient irritable, anxious, and very easily excited and angered. He often had flushing up and dizziness. Dr. Chang decided to use bitter (taste) and cold (qi) to clear heat and cool blood. His prescription consisted of: Huanglian 10g Huang qin 15g dahuang 7g shengdi 20g maimendong 15g chishao 15g shihu 15g yinchenhao 15g pipaye 15g gancao 10g On the second visit, on July 2, 1992, this patient had taken this prescription for eight days and the heat was much reduced with his dizziness lessened. His tongue was red, with a thin white coat and his pulse was wiry and slow. Dr. Chang modified the prescription was follows: Huanglian 10g huangqin 15g dahuang 7g shengdi 20g maimendong 15g baishao 15g shihu 15g yinchenhao 15g pipaye 15g gancao 10g zhike 15g juhua 15g sangye 15g On the third visit, on July 10, this patient had taken this modified prescription for six days. All his symptoms were much improved, but he still had some slight attacks. Dr. Chang decided to add some sedate yang herbs. The new prescription included: Daizhishe 30g huanglian 10g haungqin 15g dahuang 7g muli 20g zhenzhumu 30g shengdi 20g xuanshen 20g longdancao 10g huai niuxi 15g shen gancao 10g On the patient’s fourth visit, July 17, he had taken this prescription for six days, and all his symptoms had disappeared. But then, because of stress, they started to come back, but not as strongly as before. Dr. Chang prescribed the following: Huanglian 10g haungqin 15g dahuang 10g taoren 15g daizhishi 30g zhenzhumu 30g longdancao 10g Zhi Zi (Gardeniae Jasminoidis, Fructus) 10g mudanpi 15g shengdi 20g yinchenhao 15g shen muli 20g gancao 10g maimendong 15g The patient took this last formula for six days and all his symptoms completely disappeared. Dr. Chang believed that stirring of the ministerial fire (xiang huo wang dong) caused this patient’s dizziness. Different scholars have had different opinions about the nature of this ministerial fire. Xian Ke Chao believed that ministerial fire is stored in the kidney and is the same as life gate fire. When there is insufficiency of liver-kidney yin, this ministerial fire can become vacuity fire flaming upward in patterns such as hyperactive liver yang or kidney effulgent fire with symptoms such as dizziness, headache, unclear vision, irascibility, etc. The proper treatment strategy is to bring vacuity fire back to the kidney. Li Shi Zhen, in the other hand, thought that ministerial fire was pericardium fire. He thought that since the heart stores the spirit (shen) and is the sovereign fire, the pericardium, being right next to the heart, stores the ministerial fire. If this ministerial fire is out of control it is replete in nature, and can cause palpitations, red face, irritability, and dizziness. Here the treatment strategy must be to clear repletion heat. Dr. Chang thought that both theories applied in Chang’s case. Chang had both vacuous and replete fire, i.e.: pericardium fire and kidney vacuity with yang rising. The treatment principle had to include both supplementing yin and sedating yang, bringing the fire back to the kidney and clearing pericardium fire. Get your FREE download of MSN Explorer at http://explorer.msn.com Quote Link to comment Share on other sites More sharing options...
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